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. 2021 Jan 23;16(1):46.
doi: 10.1186/s13023-021-01691-x.

The congenital sternoclavicular sinus: a single-institution retrospective study of 88 patients

Gang Yang  1 , Taozhen He  2
Affiliations

The congenital sternoclavicular sinus: a single-institution retrospective study of 88 patients

Gang Yang et al. Orphanet J Rare Dis. .

Abstract

Background: Sinus near the sternoclavicular joint was considered as a rare congenital neck abnormality. Though it was reported as a dermoid sinus in some literatures, the embryological origin of the sinus was unclear. This study aimed at reviewing the clinical and histological characteristics and analyzing the possible embryological origin of this malformation in children.

Methods: The medical records of all patients with congenital sternoclavicular sinus who underwent surgical resection between March 2018 through June 2020 were reviewed retrospectively. The clinical presentations, complications, histological examination, and treatment were analyzed.

Results: Of the 88 patients with congenital sternoclavicular sinus included, the mean age of surgery was 2.73 ± 1.71 years old. The sinuses occurred on the left side in 73 (83.0%) cases. Sixty-three patients experienced sinus infection and 44 patients underwent incision and drainage before excision. All patients received surgical resection with one patient who recurred after surgery. Histopathological examination showed that the sinuses were lined by squamous epithelium in most patients. However, ciliated epithelium was observed in one patient and salivary glands were detected in two patients.

Conclusions: The congenital sternoclavicular sinus should be excised promptly to prevent recurrent infection. According to the ciliated epithelium and salivary gland were found in the wall of sinus, it should be viewed as the skin side remnant of the fourth branchial cleft rather than a dermoid cyst/sinus.

Keywords: Branchial cleft anomaly; Children; Dermoid fistula.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Right congenital sternoclavicular sinus in a 20 months old girl. b Left sternoclavicular sinus in a 5 years old girl with recurrent infection. c Left sternoclavicular sinus in a 2 years old boy; d Dissection of the sinus with a catheter indwelling
Fig. 2
Fig. 2
Histological examination of the fistula (×10, hematoxylin and eosin staining). a The sinus was lined with squamous epithelium and contained abundant keratinous material and sebum in the lumen. b Remnant of salivary gland was detected in the sinus
See this image and copyright information in PMC

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